Smartphone as a tool for evaluating oblique muscle dysfunction

Abstract

The aim of this study was to describe a simple, accessible, and reliable method using a smartphone for evaluating oblique muscle dysfunctions. Methods: The photograph rotation tool in the iPhone PHOTO app was used by 75 examiners to evaluate 22 photographs from only 9 patients, captured in infra-and supra-dextroversion, and infra-and supra-levoversion, as not all the patients were photographed in the 4 positions mentioned. Each patient received a score for the superior and inferior oblique muscle functions, ranging from -4 (hypofunction) to 4 (hyperfunction) or 0 (normal function), using preediting and postediting photographs. These values were compared with the scores previously given by trained personnel in strabismus screening. The difference in score between the two groups was expressed in natural (whole and non-negative) numbers. The mean and pattern deviation were then calculated. Results: The scores of most of the edited photos showed a lower mean than those of the unedited ones, except for a patient with left superior oblique hyperfunction. The patients with no oblique dysfunction and those with right superior oblique hyperfunction demonstrated (after editing the photograph) scores with greater similarity with their initial scores (p<0.05 and p<0.01, respectively). Similar results were found in the patients with oblique hypofunctions and right inferior oblique hyperfunction (p<0.01). Conclusion: The proposed method for assessing muscular function in vertical strabismus is reproducible, accessible, simple, and reliable, and provides better consistency to the admeasurement.

Automated photographic analysis of inferior oblique overaction based on deep learning

“…An angular difference of 5 degrees was defined as 1 unit of overaction (10). Rautha et al used the photograph rotation tool in the iPhone Photo app to evaluate IO muscle functions, with a grid image overlapped on the photograph and the grade line positioned on the inferior corneal limbus of the abducted eye/fixing eye in supra-levoversion and supra-dextroversion (11). However, manual process of photographs was still required in previous studies, which leads to inefficiency and inevitable artificial error.…”

“…Several efforts have been made to quantitatively assess IOOA using photographs of the cardinal positions of gaze (9)(10)(11). However, human-computer interaction was still required for photographic analysis in previous studies, leading to subjectivity in the measurement.…”